Release of Information
I hereby authorize the release of information to Canyon View Vineyard Church
(CVVC) to receive the assistance I am requesting. I further certify the information I
have stated is true and correct. I understand and give CVVC permission to verify
the information on this application and to discuss my case with other agencies,
businesses, churches, attorneys, individuals, and any others deemed necessary to
verify application information. I understand that all information will remain as
confidential as possible within these entities.

I have read, understood, and agree to the policies above regarding the Release of